The pressures of reduced training hours, increased numbers of procedures to master, demands for operating room usage efficiency, and maximizing performance of services whose costs can be recovered has impacted the traditional ways of patient-centric surgeon training. Technology is being increasingly incorporated into the process, especially in minimally invasive procedures in the form of computer-based interactive skills trainers. Yet the majority of surgery is still performed through open-incision access and there are no simulation-based training systems available for this training. The foundation for open surgery training is wound closure and this is the simulation that will be built in this proposal. This work builds upon earlier prototype work that has proved the fundamental concept is possible. Taking that as a starting point, this effort will refine physics-based simulation of tool-tissue interaction and implement training content for wound closure that conforms with recently announced curricula for surgical resident training. The underlying simulator architecture that results will serve as a platform for additional training content in the future. The outcome of this proposal will be a cost appropriate simulator that is ready to go to the next stage of commercialization, where it can meet the needs of surgeons in addition to those of many other groups of healthcare professionals who need basic wound closure training. [unreadable] PUBLIC HEALTH RELEVANCE: The wound closure training simulator that will result from this proposed effort will meet the training needs of numerous groups of US healthcare workers, from surgical residents to nurses to emergency medical technicians to military medics. It will provide an effective means of broadly providing consistent best-practices teaching in diverse locations. The result will be a better-trained healthcare workforce that will provide more effective care to the public. [unreadable] [unreadable] [unreadable]